Individual
JOSEPH FULLEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ACDP, ICADC, LMHC
Contact information
Practice address
20 HAMILTON DR, EAST GREENWICH, RI 02818-2109
(401) 516-4204
Mailing address
PO BOX 553, EAST GREENWICH, RI 02818-0553
(401) 516-4204
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
CDP00201
RI
101YM0800X
Mental Health Counselor
Primary
MHC00788
RI
Other
Enumeration date
03/05/2010
Last updated
05/03/2025
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